Wegener's Granulomatosis - Treatment

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How is Wegener's granulomatosis treated?

Wegener's granulomatosis is a serious disease and without treatment can be fatal within months. Treatment is directed toward stopping the inflammation process by suppressing the immune system.

Medications used to treat Wegener's granulomatosis include high-dose cortisone (prednisone) and the immunosuppressive drug cyclophosphamide (Cytoxan). Recent reports also suggest that trimethoprim/sulfamethoxazole (Bactrim) can also be helpful to prevent relapse of disease activity in patients with Wegener's granulomatosis.

Cytoxan that is taken by mouth with prednisone until the disease is in remission and then switched to methotrexate for two years and tapered off has been reported to be effective and less toxic than the traditional long-term Cytoxan treatment.

Methotrexate has recently been introduced as a drug for Cytoxan treatment failures. Moreover, it now appears that Cytoxan will not be necessary in order to maintain long-term remission and that doctors can convert to the less toxic methotrexate for maintenance. The reports also demonstrate that methotrexate can eventually be tapered off entirely after two years. Azathioprine (Imuran) has also been used as a maintenance medication after Cytoxan. Recently, intravenous immunoglobulin therapy (IVIG) has been shown to be helpful in treating relapses of Wegener's granulomatosis. Also, preliminary studies suggest that rituximab (Rituxan) may be helpful to maintain remission once the initial inflammatory disease has been controlled using medications mentioned above. These new regimens are welcome news for patients with Wegener's granulomatosis as medical researchers are searching for better treatments.

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Comment from: K M, 55-64 Male (Patient) Published: April 11

I was diagnosed in 2005 with Wegener"s granulomatosis after multiple sinus infections, fevers and sickness. Doctors kept giving me antibiotics but I kept getting sicker. I was on Cytoxan and 100 mg prednisone for a year which caused necrosis of my hip. I had a hip replacement. Also, now I have severe peripheral neuropathy. I felt better but remission did not last and I ended up in hospital for Rituxan infusions. My mental capacity has been affected, as well as my stamina. The doctor wants to repeat Rituxan treatments again. I really don"t want to, but as I felt better and tried to do more daily, I am now having bloody discharge from sinuses again. It"s been a battle with ups and downs. I am grateful for the days I do feel pretty good.

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Comment from: Mucjud13, 55-64 Female (Patient) Published: June 02

Update on my treatment for Wegener"s granulomatosis: the Imuran after several months spiked my liver enzymes to 88! My rheumatologist called and I was to stop immediately my 150 mg a day. About 5 weeks later, I was switched to Rituxan Infusions. All this happened recently between February 2014 and present May 2014.

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